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Panelist discusses the clinical patient, a 72-year-old man who was previously diagnosed 6 years ago with multiple myeloma, 60% plasma cells, which he presents to his oncologist after 5 prior treatment regimens. The patient also has had 2 episodes of pneumonia and multiple episodes of bronchitis over the prior 10 years.

Along with the Oncology Brothers, Paolo Tarantino, MD, discusses the post -hoc subgroup analysis from the EMERALD study (SABCS 2023), which examined outcomes in patients with ESR1 mutations (ESR1m) who had been on CDK4/6 inhibitors (CDK4/6i) plus endocrine therapy for 12 months or longer, and shares her his perspectives on how these findings may influence the use of elacestrant in ER+/HER2–- metastatic breast cancer (MBC) and impact clinical practice for community oncologists.

Along with the Oncology Brothers, Paolo Tarantino, MD, elaborates on results from an analysis of data from the EMERALD study that were reported at the San Antonio Breast Cancer Symposium (SABCS) 2022. This analysis identified duration of prior CDK4/6 inhibitor therapy as a potential surrogate marker for endocrine sensitivity, and discusses how these findings could help guide patient selection for elacestrant.

Joshua K. Sabari, MD, evaluates the objective clinical outcomes of emerging targeted therapies for ES-SCLC, comparing them with second-line topotecan and CAV regimens, while discussing the potential of various compounds for platinum-sensitive vs platinum-resistant subgroups. He also considers the applicability of TIGIT immunotherapy, highlighting the need for robust clinical trial data on its safety and efficacy as both monotherapy and in combination, and he reflects on whether tiragolumab is more suited for chemotherapy-naive non–small cell lung cancer than for ES-SCLC, based on the phase 2 CITYSCAPE trial results.

Joshua K. Sabari, MD, discusses the antitumor activity of second-line lurbinectedin, noting an ORR of 45%, a median DOR of 6.2 months, and a median OS of 11.2 months in patients with relapsed SCLC, and emphasizes the need for further studies to validate these findings in those with longer chemotherapy-free intervals while considering factors that may lead to lurbinectedin’s use over chemotherapy in candidates for platinum rechallenge, as well as the potential role of G-CSFs for prophylaxis.